Restoring function and esthetics in a patient with amelogenesis imperfecta: a case report.

Amelogenesis imperfecta is a hereditary disorder that affects enamel on primary and permanent teeth. It is a rare dental disease but represents a major restorative challenge for the dentist. A 14-year-old boy presented with sensitive, discolored, and mutilated teeth and a decreased vertical dimension of occlusion. The aim of treatment was to reduce dental sensitivity, to restore esthetics, and to correct the vertical dimension of occlusion. To modify the occlusion, and to protect the dentin from chemical and thermal attacks, nickel-chrome onlays were placed on the molars. To improve the esthetics of the incisors and premolars, resin composite restorations were applied. The patient was regularly recalled during the postoperative period. Radiographic and clinical examinations 10 months posttreatment revealed no evidence of disorders associated with the restored teeth or their supporting structures.     

Dual-etched implants loaded after 1- and 2-month healing periods: a histologic comparison in baboons

The purpose of this study was to evaluate the effect of early loading of Osseotite dual acid-etched commercially pure titanium dental implants in an established baboon model. Implant sites were prepared by removal of premolars and first molars at maxillary and mandibular sites in 10 adult female baboons (Papio anubis). The resultant edentulous ridges were allowed to heal for 6 weeks. Following the placement of 80 implants, 2-mm healing abutments were placed on each implant and protruded through the mucosa after flap closure. Each implant was functionally loaded with a single crown after either 1 month (n = 40) or 2 months (n = 40) of implant healing. All implants were removed in block section after 3 months of functional loading and prepared for histologic evaluation. Photographs of histologic slides were digitized for data collection. The amount of osseous tissue contact along the implant surface in the buccolingual plane was determined using image analysis. The fraction of direct bone-tissue contact along a standardized region of each implant perimeter was calculated and compared using analysis of variance. Implants loaded after 1 month of healing had a mean of 76.6% + 14.4% bone contact, and implants loaded after 2 months of healing had a mean of 77.2% +/- 12.2% bone contact. Statistically, the 1- and 2-month groups were similar (P = .81). No implant failures were observed in either treatment group. Reducing the surgical healing time from 2 months to 1 month did not statistically affect the amount of bone observed at the tissue-implant interface in baboons under functionally loaded conditions.     

Oral soft tissue manifestations in HIV-positive vs. HIV-negative children from an inner city population: a two-year observational study

PURPOSE: Data accrued after two years of longitudinal observation of oral soft tissue lesions in a cohort of HIV-infected children and comparisons to a group of uninfected controls is presented. SUBJECTS AND METHODS: One hundred and four HIV-positive subjects were enrolled from an inner city pediatric HIV clinic and HIV-negative household peers served as control. Oral exams were performed at six-month intervals while laboratory data of interest were obtained from the children's medical records. RESULTS: HIV-positive children had significantly more oral soft tissue lesions than their HIV-negative peers. In particular, the prevalence of candidiasis, linear gingival erythema and median rhomboid glossitis were high. However, oral lesions were not good predictors of mortality and only candidiasis was associated with a low CD4 count. CONCLUSIONS: Oral soft tissue lesions were common among HIV-positive children. While candidiasis was correlated with advanced disease, oral lesions were not good predictors of mortality.     

Effects of nicotine on the strength of attachment of gingival fibroblasts to glass and non-diseased human root surfaces

BACKGROUND: The aim of this study was to evaluate the effect of nicotine on the strength of attachment of human gingival fibroblast cells to glass and non-diseased human root surfaces. METHODS: Human gingival fibroblast cells (HGF) were trypsinized, suspended in RPMI 1640 medium, and incubated with autoclaved human root and glass sections and nicotine (NIC) concentrations of 0 (control), 25, 50, and 100 ng/ml for 1 week. HGF attached and grew on glass and root surfaces for 4 weeks at all NIC concentrations. HGF cultures were subjected to a rotary shaker machine for 30 minutes to test the strength of attachment of these cells at 100, 150, and 200 rpm. The root and glass sections were examined at 48 hours by light microscopy. RESULTS: Control groups exhibited a monolayer of long, spindle-shaped fibroblasts with a parallel alignment and minimal overlapping. With a concentration of NIC of 50 or 100 ng/ml as well as with increasing "speeds," the number of cells attached to these surfaces decreased dramatically. When 200 rpm was used for both groups at all NIC concentrations, very few HGF remained attached to these surfaces. CONCLUSIONS: This study showed that the nature of cell attachment to either glass or root surfaces is altered by nicotine, and marked detachment was noted when nicotine exposure was coupled with vigorous agitation at different rpm. Marked detachment noted in all specimens at 200 rpm indicates that this speed is excessive for use in subsequent experimentation.     

Inhibition of human gingival gelatinases (MMP-2 and MMP-9) by metal salts.

OBJECTIVES: The interaction between metal ions and the oral environment is a major subject matter in dental research. Matrix metalloproteinases (MMPs) have been implicated in several pathologic oral processes such as periodontal tissue destruction, root caries, tumour invasion and temporomandibular joint disorders. The aim of this work was to test the effect of Zn, Cu, Sn and Hg ions on the activity of the major gingival gelatinolytic MMPs. METHODS: Gingival explants were cultured overnight in DMEM and the activity of secreted enzymes was analyzed by gelatin zymography in buffers containing different metal ion concentrations. The major gelatinolytic proteinases present in the conditioned media were characterized as MMP-2 and MMP-9 by immunoprecipitation with specific antibodies. The eletrophoretic bands were scanned and the transmittance values were analyzed with the Sigmagel software (Sigma). RESULTS: ZnSO4 was a strong inhibitor of MMP-2 (I50 = 15 microM) and MMP-9 (I50 = 40 microM), whereas CuSO4, HgSO4 and SnCl2 showed less efficient inhibition potential. SIGNIFICANCE: Our findings show that the activity of oral tissue MMPs may be modulated by metal ions present in the oral environment. Therefore, the accumulation of metals in connective tissue may interfere with the formation and resorption of the extracellular matrix components.     

Anesthetic efficacy of the supplemental intraosseous injection for teeth with irreversible pulpitis

The purpose of this study was to determine the efficacy of a supplemental intraosseous injection (IOI) of 2% lidocaine with 1:100,000 epinephrine using the Stabident device, after conventional anesthetic methods had failed. Patients who experienced pain during endodontic access and required a supplemental IOI using 0.45 to 0.90 ml of the local anesthetic were identified. All 37 of the patients treated had teeth diagnosed with irreversible pulpitis. Thirty-four of the teeth were mandibular posterior teeth, 2 were maxillary posterior teeth, and 1 was a maxillary anterior tooth. Patients with maxillary teeth had received infiltration anesthesia, and those with mandibular teeth had received an inferior alveolar nerve block in conjunction with long buccal infiltration. A minimum of 3.6 ml of local anesthetic was used with the conventional techniques. Modified visual analogue scales, coupled with operator evaluations, were used to measure success. The Stabident IOI was an effective supplemental anesthetic technique in 89% (+/- 5.1) or 33/37 patients evaluated. The 95% confidence interval was 74 to 97%. The IOI was successful in 91% (+/- 4.9) of the mandibular posterior teeth (31/34), and 67% of the maxillary teeth (2/3).     

Calcium hydroxide and a corticosteroid-antibiotic association as dressings in cases of biopulpectomy. A comparative study in dogs' teeth

The subject of this paper was to study the behavior of the periapical tissues of dogs' teeth after biopulpectomy and dressing with calcium hydroxide or a corticosteroid-antibiotic association, before root canal filling with zinc oxide eugenol (ZOE) or Sealapex sealers. The teeth were overinstrumented and dressed for 7 days before the root canal filling. The animals were sacrificed 180 days after treatment and the specimens were prepared for morphological analysis. Specimens treated with Sealapex presented a higher number of cases with biological closure than ZOE. When the root canals were filled with ZOE, better results were observed with the use of the Ca(OH)2 dressing.     

Relationship between clinical probing depth and reactivity to the BANA test of samples of subgingival microbiota from patients with periodontitis

The enzymatic test BANA (N-benzoyl-DL-arginine-naphthylamide) was used to analyze the subgingival microbiota of 28 patients aged 26 to 55 years old with a diagnosis of adult periodontitis. Samples were collected with periodontal curettes at 513 sites, with a mean number of sites of 18.3 +/- 8.8 per patient. The results of the BANA test were correlated with the initial measurements of pocket depth. The data showed a statistically significant correlation between increasing probing depth and a positive BANA test. BANA test detected the presence of BANA-positive microorganisms at sites of < 3 mm probing depth in a statistically significant proportion. Negative (BANA 1) and weakly positive (BANA 2) BANA tests were inversely correlated with increasing pocket depth, and positive (BANA 3) BANA tests were directly correlated with increasing pocket depth. On the basis of the presents results, we consider the BANA test to be of practical applicability in periodontal clinical practice and to represent an important auxiliary diagnostic tool for patients with adult periodontitis.     

Contralateral masking effects on cerebral auditory evoked potentials in man: a trial in working practice application in conservative dentistry]

In hearing the masking consists to disturb the information perception which means its reception, codeage and transmission are distorted in the auditory system. The electrophysiological technique by auditory evoked potentials on brain has permitted to study the noise effects with homolateral and contralateral masking method in monaural hearing. The results show that the noise distorts the maximal amplitude of the evoked response and lengthens latency. They do to appear a better resistance of a left ear preference and a superiority of right hemisphere corresponding: they characterize by an important development of auditory evoked potentials with or without masking. As a result for men who are exposed to excessive noise like teachers and students in Odontology, we suggest an inequality protection of auditory system considering the both ear sensibility difference.     

Determining the temperature rise in the pulp and at the root surface during pin hole drilling and placing of dentine pins

The purpose of this study was to determine the temperature at specific sites in the pulp and periodontium during consecutive dentine pin placement. Twenty extracted human permanent lower first molar teeth were used, cut flat at a depth of 2 mm from the occlusal surface and Titanium pins of medium size placed 1 mm inside the dentinoenamel junction. The middle of the mesial root, mesial apex and the bifurcation were sites of evaluation of the temperature of the periodontium using a thermocouple. Measurements of the temperature change in the pulp chamber were also performed. Consecutive hole drilling and placing of four pins caused a statistically significant increase in temperature in the pulp chamber, but failed to show a significant temperature rise at the root surface. The maximum temperature rises were below those reported to threaten pulpal and periodontal health.